Kinematic and Kinetic Interactions During Normal and ACL-Deficient Gait: A Longitudinal In Vivo Study

The interactions between different tissues within the knee joint and between different kinematic DOF and joint flexion during normal gait were investigated. These interactions change following ACL transection, in both short (4 weeks) and long (20 weeks) term. Ten skeletally mature sheep were used in control (N = 5) and experimental (N = 5) groups. The 6-DOF stifle joint motion was first measured during normal gait. The control group were then euthanized and mounted on a unique robotic testing platform for kinetic measurements. The experimental group underwent ACL transection surgery, and kinematics measurements were repeated 4 and 20 weeks post-operatively. The experimental group were then euthanized and underwent kinetic assessment using the robotic system. Results indicated significant couplings between joint flexion vs. abduction and internal tibial rotation, as well as medial, anterior, and superior tibial translations during both normal and ACL-deficient gait. Distinct kinetic interactions were also observed between different tissues within the knee joint. Direct relationships were found between ACL vs. LM/MM, and PCL vs. MCL loads during normal gait; inverse relationships were detected between ACL vs. PCL and PCL vs. LM/MM loads. These kinetic interaction patterns were considerably altered by ACL injury. Significant inter-subject variability in joint kinematics and tissue loading patterns during gait was also observed. This study provides further understanding of the in vivo function of different tissues within the knee joint and their couplings with joint kinematics during normal gait and over time following ACL transection.

[1]  Reed Ferber,et al.  Gait mechanics in chronic ACL deficiency and subsequent repair. , 2002, Clinical biomechanics.

[2]  Shu-guang Gao,et al.  Impact of Partial and complete rupture of anterior cruciate ligament on medial meniscus: A cadavaric study , 2012, Indian journal of orthopaedics.

[3]  Li-Qun Zhang,et al.  Six degrees-of-freedom kinematics of ACL deficient knees during locomotion-compensatory mechanism. , 2003, Gait & posture.

[4]  L. Snyder-Mackler,et al.  Knee instability after acute ACL rupture affects movement patterns during the mid‐stance phase of gait , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[5]  C. Frank,et al.  There is significant load sharing and physical interaction between the anteromedial and posterolateral bundles of the ovine ACL under anterior tibial loads. , 2012, The Knee.

[6]  Savio L-Y Woo,et al.  Biomechanics and anterior cruciate ligament reconstruction , 2006, Journal of orthopaedic surgery and research.

[7]  Marcus G Pandy,et al.  Comparison of shear forces and ligament loading in the healthy and ACL-deficient knee during gait. , 2004, Journal of biomechanics.

[8]  Janet E Tapper,et al.  Dynamic in vivo three‐dimensional (3D) kinematics of the anterior cruciate ligament/medial collateral ligament transected ovine stifle joint , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[9]  Kurt Manal,et al.  An electromyogram-driven musculoskeletal model of the knee to predict in vivo joint contact forces during normal and novel gait patterns. , 2013, Journal of biomechanical engineering.

[10]  T W Rudy,et al.  In-situ force in the medial and lateral structures of intact and ACL-deficient knees , 2000, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[11]  E. Roos,et al.  Knee kinematics and kinetics during gait, step and hop in males with a 16 years old ACL injury compared with matched controls , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.

[12]  Scott Tashman,et al.  Kinematics of the ACL‐deficient canine knee during gait: Serial changes over two years , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[13]  T. Andriacchi,et al.  Interactions between kinematics and loading during walking for the normal and ACL deficient knee. , 2005, Journal of biomechanics.

[14]  J. Slauterbeck,et al.  Risk Factors for Anterior Cruciate Ligament Injury , 2012, Sports health.

[15]  M. Pandy,et al.  Muscle, ligament, and joint-contact forces at the knee during walking. , 2005, Medicine and science in sports and exercise.

[16]  Ramprasad Papannagari,et al.  The effects of ACL deficiency on mediolateral translation and varus–valgus rotation , 2007, Acta orthopaedica.

[17]  Benjamin J Ellis,et al.  Medial collateral ligament insertion site and contact forces in the ACL‐deficient knee , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  E S Grood,et al.  A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. , 1983, Journal of biomechanical engineering.

[19]  Janet L Ronsky,et al.  Dynamic in vivo kinematics of the intact ovine stifle joint , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  J. Hart,et al.  Quadriceps activation following knee injuries: a systematic review. , 2010, Journal of athletic training.

[21]  S. Woo,et al.  Contribution of biomechanics to management of ligament and tendon injuries. , 2008, Molecular & cellular biomechanics : MCB.

[22]  Antonis P. Stylianou,et al.  Simulation of Anterior Cruciate Ligament Deficiency in a Musculoskeletal Model with Anatomical Knees , 2012, The open biomedical engineering journal.

[23]  S. B. Adams,et al.  The surgical anatomy of the stifle joint in sheep. , 1998, Veterinary surgery : VS.

[24]  Y. Toyama,et al.  Coordination of the anterior and posterior cruciate ligaments in constraining the varus–valgus and internal–external rotatory instability of the knee , 2002, Journal of Orthopaedic Science.

[25]  Seungbum Koo,et al.  A Framework for the in Vivo Pathomechanics of Osteoarthritis at the Knee , 2004, Annals of Biomedical Engineering.

[26]  Thomas P Andriacchi,et al.  Secondary motions of the knee during weight bearing and non‐weight bearing activities , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[27]  Janet E Tapper,et al.  ACL/MCL transection affects knee ligament insertion distance of healing and intact ligaments during gait in the Ovine model. , 2009, Journal of biomechanics.

[28]  R. Kiss,et al.  Gait adaptation in ACL deficient patients before and after anterior cruciate ligament reconstruction surgery. , 2004, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[29]  A Shirazi-Adl,et al.  Biomechanics of passive knee joint in drawer: load transmission in intact and ACL-deficient joints. , 2003, The Knee.

[30]  B. Nigg,et al.  Biomechanics of the musculo-skeletal system , 1995 .

[31]  Ramprasad Papannagari,et al.  The 6 Degrees of Freedom Kinematics of the Knee after Anterior Cruciate Ligament Deficiency , 2006, The American journal of sports medicine.

[32]  Ramprasad Papannagari,et al.  The Effect of Anterior Cruciate Ligament Deficiency on the in Vivo Elongation of the Medial and Lateral Collateral Ligaments , 2007, The American journal of sports medicine.

[33]  T. Gill,et al.  In Vivo Elongation of the Anterior Cruciate Ligament and Posterior Cruciate Ligament during Knee Flexion , 2004, The American journal of sports medicine.

[34]  A. Burstein.  Basic Biomechanics of the Musculoskeletal System. 3rd ed. , 2001 .

[35]  Freddie H. Fu,et al.  The Biomechanical Interdependence between the Anterior Cruciate Ligament Replacement Graft and the Medial Meniscus * , 2001, The American journal of sports medicine.

[36]  Pierre Hepp,et al.  Comparative anatomical measurements of osseous structures in the ovine and human knee. , 2011, The Knee.

[37]  Trent M. Guess,et al.  Simulation of Anterior Cruciate Ligament Deficiency in a Musculoskeletal Model with Anatomical Knees , 2012 .

[38]  Ali Hosseini,et al.  Anteroposterior stability of the knee during the stance phase of gait after anterior cruciate ligament deficiency. , 2012, Gait & posture.

[39]  B. Beynnon,et al.  Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non‐weightbearing to weightbearing , 2002, Journal of Orthopaedic Research.

[40]  S. Woo,et al.  Interspecies variation of compressive biomechanical properties of the meniscus. , 1995, Journal of biomedical materials research.